Actigraphy Studies and Clinical and Biobehavioural Correlates in Schizophrenia: a Systematic Review

Overview

Journal J Neural Transm (Vienna)

Specialties Neurology
Physiology

Date 2019 Mar 20

PMID 30888511

Citations 20

Authors

Zi Ying Wee

Samantha Wei Lee Yong

Qian Hui Chew

Cuntai Guan

Tih Shih Lee

Kang Sim

Affiliations

Soon will be listed here.

Abstract

Actigraphy is a non-invasive method of monitoring circadian rhythms and motor activity. We systematically reviewed extant evidence until September 2018 pertaining to actigraphy use in schizophrenia, its clinical/biological correlates and posit future research directions. Within 38 included studies involving 2700 subjects, patients with schizophrenia generally have lower motor activity levels, poorer sleep quality and efficiency, increased sleep fragmentation and duration compared with healthy controls. Lowered motor activity and longer sleep duration in patients were associated with greater severity of negative symptoms. Less structured motor activity and decreased sleep quality were associated with greater severity of positive symptoms, worse cognitive functioning involving attention and processing speed, illness chronicity, higher antipsychotic dose, and poorer quality of life. Correlations of actigraphic measures with biological factors are sparse with inconclusive results. Future studies with larger sample sets may adopt a multimodal, longitudinal approach which examines both motor and sleep activity, triangulates clinical, actigraphic and biological measures to clarify their inter-relationships and inform risk prediction of illness onset, course, and treatment response over time.

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References

Poyurovsky M, Nave R, Epstein R, Tzischinsky O, Schneidman M, Barnes T . Actigraphic monitoring (actigraphy) of circadian locomotor activity in schizophrenic patients with acute neuroleptic-induced akathisia. Eur Neuropsychopharmacol. 2000; 10(3):171-6. DOI: 10.1016/s0924-977x(00)00063-8. View

Shamir E, Laudon M, Barak Y, Anis Y, Rotenberg V, Elizur A . Melatonin improves sleep quality of patients with chronic schizophrenia. J Clin Psychiatry. 2000; 61(5):373-7. DOI: 10.4088/jcp.v61n0509. View

Krebs M, Gut-Fayand A, Bourdel M, Dischamp J, Olie J . Validation and factorial structure of a standardized neurological examination assessing neurological soft signs in schizophrenia. Schizophr Res. 2000; 45(3):245-60. DOI: 10.1016/s0920-9964(99)00206-6. View

Haug H, Wirz-Justice A, Rossler W . Actigraphy to measure day structure as a therapeutic variable in the treatment of schizophrenic patients. Acta Psychiatr Scand Suppl. 2001; (407):91-5. DOI: 10.1034/j.1600-0447.2000.00018.x. View

Ancoli-Israel S, Cole R, Alessi C, Chambers M, Moorcroft W, Pollak C . The role of actigraphy in the study of sleep and circadian rhythms. Sleep. 2003; 26(3):342-92. DOI: 10.1093/sleep/26.3.342. View

Kiang M, Daskalakis Z, Christensen B, Remington G, Kapur S . Actigraphic measurement of the effects of single-dose haloperidol and olanzapine on spontaneous motor activity in normal subjects. J Psychiatry Neurosci. 2003; 28(4):293-9. PMC: 165794. View

Martin J, Jeste D, Ancoli-Israel S . Older schizophrenia patients have more disrupted sleep and circadian rhythms than age-matched comparison subjects. J Psychiatr Res. 2005; 39(3):251-9. DOI: 10.1016/j.jpsychires.2004.08.011. View

Hofstetter J, Lysaker P, Mayeda A . Quality of sleep in patients with schizophrenia is associated with quality of life and coping. BMC Psychiatry. 2005; 5:13. PMC: 554780. DOI: 10.1186/1471-244X-5-13. View

Chouinard S, Poulin J, Stip E, Godbout R . Sleep in untreated patients with schizophrenia: a meta-analysis. Schizophr Bull. 2005; 30(4):957-67. DOI: 10.1093/oxfordjournals.schbul.a007145. View

10.

Lieberman 3rd J . Metabolic changes associated with antipsychotic use. Prim Care Companion J Clin Psychiatry. 2005; 6(Suppl 2):8-13. PMC: 487012. View

11.

Farrow T, Hunter M, Wilkinson I, Green R, Spence S . Structural brain correlates of unconstrained motor activity in people with schizophrenia. Br J Psychiatry. 2005; 187:481-2. DOI: 10.1192/bjp.187.5.481. View

12.

Wulff K, Joyce E, Middleton B, Dijk D, Foster R . The suitability of actigraphy, diary data, and urinary melatonin profiles for quantitative assessment of sleep disturbances in schizophrenia: a case report. Chronobiol Int. 2006; 23(1-2):485-95. DOI: 10.1080/07420520500545987. View

13.

Ancoli-Israel S, Kripke D, Klauber M, MASON W, Fell R, Kaplan O . Sleep-disordered breathing in community-dwelling elderly. Sleep. 1991; 14(6):486-95. PMC: 2756990. DOI: 10.1093/sleep/14.6.486. View

14.

Walther S, Horn H, Koschorke P, Muller T, Strik W . Increased motor activity in cycloid psychosis compared to schizophrenia. World J Biol Psychiatry. 2008; 10(4 Pt 3):746-51. DOI: 10.1080/15622970701882425. View

15.

Manoach D, Thakkar K, Stroynowski E, Ely A, McKinley S, Wamsley E . Reduced overnight consolidation of procedural learning in chronic medicated schizophrenia is related to specific sleep stages. J Psychiatr Res. 2009; 44(2):112-20. PMC: 2813320. DOI: 10.1016/j.jpsychires.2009.06.011. View

16.

Walther S, Koschorke P, Horn H, Strik W . Objectively measured motor activity in schizophrenia challenges the validity of expert ratings. Psychiatry Res. 2009; 169(3):187-90. DOI: 10.1016/j.psychres.2008.06.020. View

17.

Walther S, Horn H, Razavi N, Koschorke P, Muller T, Strik W . Quantitative motor activity differentiates schizophrenia subtypes. Neuropsychobiology. 2009; 60(2):80-6. DOI: 10.1159/000236448. View

18.

Perry W, Minassian A, Paulus M, Young J, Kincaid M, Ferguson E . A reverse-translational study of dysfunctional exploration in psychiatric disorders: from mice to men. Arch Gen Psychiatry. 2009; 66(10):1072-80. PMC: 2897252. DOI: 10.1001/archgenpsychiatry.2009.58. View

19.

Sadeh A, Lavie P, Scher A, Tirosh E, Epstein R . Actigraphic home-monitoring sleep-disturbed and control infants and young children: a new method for pediatric assessment of sleep-wake patterns. Pediatrics. 1991; 87(4):494-9. View

20.

Rishi M, Shetty M, Wolff A, Amoateng-Adjepong Y, Manthous C . Atypical antipsychotic medications are independently associated with severe obstructive sleep apnea. Clin Neuropharmacol. 2010; 33(3):109-13. DOI: 10.1097/WNF.0b013e3181db8040. View